In this paper, an objective concept analysis was undertaken to examine the attributes, characteristics and uses of the concept of empowerment. A review of the literature and selected empirical referents indicated that empowerment is a complex and multi-dimensional concept. Within a nursing context, empowerment can be conceptualized as a composite of (a) attributes that relate to the client, (b) attributes that relate to the nurse, and (c) attributes that belong to both the client and the nurse. In a broad sense, empowerment is a process of helping people to assert control over the factors which affect their lives. This process encompasses both the individual responsibility in health care and the broader institutional, organizational or societal responsibilities in enabling people to assume responsibility for their own health. Antecedents to and consequences of empowerment, from a nursing perspective, are presented. To adopt truly an empowerment model in nursing, a radical paradigm shift is needed. The final conclusion is that this concept has great utility for nursing practice, education, administration and research.

As a result of advances in scientific knowledge and technology, the number of children living with chronic illness is ever increasing. The burden of responsibility for the care of these children falls increasingly on the involved parents and, particularly, on mothers. In spite of the challenges that chronic childhood illness presents, many families are able to adapt to their situation and develop a sense of control over their lives. A sense of control has been associated with the notion of empowerment. Following a theoretical analysis, empowerment was conceptualized as a social process of recognizing, promoting and enhancing people's abilities to meet their own needs, solve their own problems, and mobilize the necessary resources in order to feel in control of their own lives. To understand the concept of empowerment from an empirical perspective, a fieldwork study was undertaken to describe the process of empowerment as it pertains to mothers of chronically ill children. This paper presents the process of empowerment that occurred in these mothers. Four components of the process of empowerment emerged: discovering reality, critical reflection, taking charge, and holding on. As a result of the study, empowerment was reconceptualized as largely a personal process in which individuals developed and employed the necessary knowledge, competence and confidence for making their voices heard. Participatory competence--the ability to be heard by those in power--was the outcome of this process. Although the unique finding in this study suggests that the process of empowerment was largely intrapersonal, there was a relational element in the process. Clearly, the intrapersonal and interpersonal processes of empowerment are intertwined.

The hybrid model, developed by Schwartz-Barcott & Kim guided the conduct of a study of empowerment in mothers of chronically ill children. Integral to the model of empowerment that emerged from the study was an ongoing process of critical reflection. Through this process, mothers became aware of their strengths, abilities and resources. This paper is an in-depth analysis of the process of critical reflection, which corroborates recent theory on women's development. The process of critical reflection is illuminated by women's ways of knowing, as exemplified in the story of one mother, and by elements of maternal thinking. Implications for nursing practice in working with mothers of chronically ill children are highlighted.

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Nursing is a manifestation of a value according to which it is morally good to promote physical and psychological well-being. Such a moral obligation involves making judgements. Ethical judgements are the decisions a person makes on whether a particular act is right or wrong. Ethical principles serve as the basis for ethical rules and as a framework for decision-making. Ethical theory provides a rationale that explains the principles and rules in order to provide a structured approach to ethical reasoning. Although ethics is not a science with verifiable answers, a knowledge of ethical theory enables nurses to make decisions in a manner that is more comprehensive and well reasoned than is opinion or intuition. In this paper, an overview of ethical theories, ethical principles and influences on ethical or moral reasoning is presented as well as the ethical decision-making process.